维生素D联合依诺肝素钠治疗对早发型重度子痫前期患者血胎盘生长因子D-二聚体及妊娠结局的影响  

Effects of vitamin D assisted enoxaparin sodium therapy on serum PLGF D-dimer and pregnancy out-comes in patients with early-onset severe preeclampsia

作　　者：黄文娟 卢莹莹 Huang Wenjuan;Lu Yingying(Department of Gynecology and Obstetrics,Yongkang Maternal and Child Health Hospital,Jinhua,Zhejiang 321300,China)

机构地区：[1]永康市妇幼保健院妇产科,浙江金华321300

出　　处：《中国药物与临床》2024年第20期1331-1336,共6页Chinese Remedies & Clinics

摘　　要：目的分析维生素D辅助依诺肝素钠治疗对早发型重度子痫前期患者血清中胎盘生长因子(PLGF)、D-二聚体(D-D)及妊娠结局的影响。方法回顾性分析浙江省永康市妇幼保健院2021年1月至2023年12月治疗的78例早发型重度子痫前期患者,根据患者意愿及治疗药物不同分为维生素组和对照组,维生素组40例采取维生素D联合依诺肝素钠治疗,对照组38例仅采用依诺肝素钠治疗。比较2组患者的疗效,临床指标[分娩时孕周、新生儿体质量、收缩压、舒张压和尿蛋白定量(24 h)],实验室指标[PLGF、D-D、25羟维生素D(25-(OH)D)和纤维蛋白原(FIB)]和妊娠结局。结果维生素组治疗疗效优于对照组(P<0.05)。维生素组分娩孕周(32.9±2.6)周,比对照组的(31.1±2.5)周晚(P<0.05);新生儿体质量(2.7±0.4)kg,比对照组的(2.2±0.3)kg更重;收缩压和舒张压分别为(125±11)mmHg和(99±10)mmHg,均低于对照组的(134±12)mmHg和(106±11)mmHg,且尿蛋白定量(24 h)为(1.3±0.3)g低于对照组的(2.6±0.5)g(均P<0.05)。治疗后,维生素组血清PLGF和25-(OH)D水平分别为(975±36)ng/L和(30±6)μg/L高于对照组的(742±33)ng/L和(23±5)μg/L;D-D、和FIB水平分别为(2.0±0.4)mg/L和(3.0±0.6)g/L,均低于对照组的(2.4±0.6)mg/L和(3.9±0.7)g/L(P<0.05)。维生素组和对照组不良妊娠结局总发生率分别为2.5%和18.4%,差异有统计学意义(P<0.05)。结论维生素D辅助依诺肝素钠治疗能有效上调早发型重度子痫前期患者血PLGF水平,降低D-D水平,且妊娠结局无明显差异。Objective To analyze the effect of vitamin D supplemented with enoxaparin sodium on serum placental growth factor(PLGF),D-dimer(D-D)and pregnancy outcomes in patients with early onset severe preeclampsia(EOSP).Methods A retrospective analysis was conducted on 78 patients with EOSP treated at the Yongkang Maternal and Child Health Hospital in Zhejiang Provincefrom January 2021 to December 2023.According to the patients′willingness and different treatment drugs,they were divided into a vitamin group and a control group.The vitamin group(n=40)received vitamin D-assisted enoxaparin sodium therapy,while the control group(n=38)only received enoxaparin sodium therapy.The efficacy,clinical indicators(gestational age at delivery,neonatal weight,systolic blood pressure,diastolic blood pressure,24-hour urinary protein),laboratory indicators[PLGF,D-D,25-(OH)D and fibrinogen(FIB)]and pregnancy outcomes were compared between the two groups.Results The treatment efficacy of the vitamin group was superior to that of the control group(P<0.05).The gestational age at delivery in vitamin group with(32.9±2.6)weeks,which was later than(31.1±2.5)weeks in the control group(P<0.05).The neonatal weight with(2.7±0.4)kg was heavier than(2.2±0.3)kg in control group,and the systolic blood pressure and diastolic blood pressure with(125±11)mmHg and(99±10)mmHg were lower than(134±12)mmHg and(106±11)mmHg in control group,and the 24-hour urinary protein with(1.3±0.3)g was lower than(2.6±0.5)g in control group(all P<0.05).After treatment,the levels of serum PLGF and 25-(OH)D with(975±36)ng/L and(30±6)μg/L in vitamin group were higher than(742±33)ng/L and(23±5)μg/L in control group while the levels of D-D and FIB with(2.0±0.4)mg/L and(3.0±0.6)g/L were lower than(2.4±0.6)mg/L and(3.9±0.7)g/L in control group(P<0.05).The total incidence of adverse pregnancy outcomes in the vitamin group and the control group were 2.5%and 18.42%(P<0.05).Conclusion Vitamin D supplemented with enoxaparin sodium can effectively up-regulate the serum

关 键 词：子痫 胆骨化醇 胎盘 妊娠结局 

分 类 号：R714.244[医药卫生—妇产科学]